When my child walks, his feet and toes point inward. Should I do anything about this?

It's a good idea to point out what you see to your child's doctor, but it's probably nothing to worry about. It's very common for young children to walk pigeon-toed (also called intoeing).

What makes a child pigeon-toed?

Intoeing usually happens when a foot, shin, or thigh rotates inward and causes the toes to turn inward too. While intoeing can be genetic, the misalignment often develops before birth, when a baby's feet or legs turn to fit in the cramped space of the womb.

If your child's lower leg (or tibia) twists inward, it's called tibial torsion. The leg tends to straighten out as it grows longer. Most often this condition corrects itself before a child heads to school.

Another common cause of intoeing is a twisted thigh bone (or femur), which is called femoral torsion. This is more common in girls than in boys and often affects both legs. If the thigh bones are rotated, the kneecaps will face in as well.

Femoral torsion often becomes obvious when a child is a preschooler, and it usually gets better by the time the child is between 6 and 8 years old.

Does intoeing need to be treated?

Probably not. Doctors used to recommend casting, braces, special shoes, and even surgery, but in most cases intoeing corrects itself without any treatment at all. In fact, experts now say that treatment can inhibit a child's ability to play and in some instances even lead to other physical problems. (In rare instances, casts or surgery may be required to correct severe intoeing.)

Talk with your child's doctor if you're at all concerned about his intoeing. She can tell you whether it's something that's likely to correct itself. If she thinks it's serious enough to need an expert eye — or that your child may have a more serious condition — she may refer you to an orthopedic specialist.

Can intoeing cause my child problems down the road?

Your child may trip if he tends to catch his toes on the opposite heel, but intoeing itself causes no pain. And it won't affect his athletic ability or cause him to develop arthritis or back trouble later on.

At any time, let the doctor know if your child is having trouble walking or running, or if you notice that his feet or legs aren't symmetrical. Take your child to the doctor if he develops pain, swelling, or a limp.

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